TRAVELLING THE JOURNEY OF RECOVERY – AND HOW TO RECORD IT

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It has been argued that the relationship between frontline drug/alcohol workers and their clients has been turned by Payment By Results into one of gathering data. A multimedia-based approach can bring humanity back to the process.

The use of software resources in the drug- and alcohol-treatment sector has grown significantly over the past decade. The broad spectrum of options in the market ranges, for example, from the apps from Hazelden aimed at reinforcing personal growth and recovery through to mandatory data-capture tools designed for the delivery of detailed information to commissioners/government, such as the newly launched Recovery Diagnostic Toolkit which provides a detailed picture of individuals in treatment and the interventions which might benefit them most effectively on their road to recovery.

Recovery workers in treatment agencies have a diverse menu of software with which to record and evidence their practice, and their clients’ progress. This can today be Tops, Bomic, Theseus or Sharepoint. They fully understand the current cultural message in the sector that “if it’s not recorded, it hasn’t happened”.

The focus is on data capture and, more recently, with RDT, on the provision of a precise snapshot of clients in treatment with a view to responding to an individual set of needs based on detail taken from the government’s National Drug Treatment Monitoring System. The latest approach, an innovative software dynamic which can be applied to the treatment process, comes from the newly-launched Recovery Spaces. It was designed by a team of engineers lead by Dr James Ohene-Djan, senior lecturer in the Department of Computing at Goldsmiths University of London, and is intended to be of equal value to government-funded community services and private treatment centres.

“MY DIARY KEPT ME GOING”

When researching Recovery Spaces, the team talked to a 25-year old west Londoner who had kept his own video diary when going through treatment at the Providence Projects in Bournemouth. “I have nothing but praise for the Provy but my own diary also helped keep me going. When I felt like packing it in, I would look back at some of my good days and brighten up. I think the chance for a rehab to use multi-media as part of someone’s treatment will only be a good thing,” he said.

CLIENT CARE PLANS: TWO-WAY ACCESS

Chula Goodenware, groupwork and ETE manager at the North Westminster Drug and Alcohol service in London, sees this as a positive initiative. “It could be useful in a range of very exciting ways. For example, the client care plan is the focal document involved in a client’s care coordination and can often become something used more by the practitioner than the client. If the client can access it online via the ‘work’ page of Recovery Spaces, it could become a navigational tool to which the client can regularly refer, enhancing their ability to progress along the treatment pathway by taking personal responsibility for their recovery process.

“Two of our most significant challenges are the need to improve client engagement and increase client retention. I can see how the simplicity of the video/audio/written options, and the ownership of the process that the software gives to clients and their recovery practitioners, could deliver significant improvements in these areas, especially regarding ease of client/practitioner communication. The system could enable us to build a base of genuine personal statements from service users, demonstrating their experiences of the treatment they are receiving, which could then be fed into Joint Strategic Needs Assessment and Joint health and Wellbeing Strategy, and will provide live data for us to critically evaluate service delivery. All in all, it’s very inspiring.”

HOW DOES IT WORK IN PRACTICE?

“This package is person-centred and adaptable to the needs of individuals, be that be in relation to diversity or unique journeys,” commented Caroline Cole, head of development at the Rehabilitation for Addicted Prisoners’ trust. “It brings recovery to life. Whereas narratives of recovery inspire, this tool brings that to another dimension with its capability across various media, not only words. Clients can take the starring role in their journey and share that with counsellors and family, bringing the process into 3-dimensional life. I wish this could be available to everyone on a recovery path: it is the difference between a black-and-white still photo and a full colour three-dimensional film.”

Recovery spaces is web-based and has four key multimedia functions for a client. It is a recovery journal or diary, a workbook, a messaging system and a library. Within those functions, the client can use the system in the way that they feel most comfortable. They can film their diary entry, record audio or write it, whichever they prefer. Their workbook can be used to suit the therapeutic approach of the service whether it is 12-step and/or CBT. Or it can be used to work on clients’ careplans. They can communicate directly with their recovery practitioner via the messaging page. And the library will contain information that the service wants to specifically provide its clients.

This is a “by people in recovery for people in recovery” project. Many of the Recovery Spaces team have personal experience of addiction and the process of recording visual change is an action that they find powerful and motivational.

One of the design team mentioned that “It is common for people in recovery to keep pictures or film of themselves when they were in active addiction as a reminder to themselves and others of the place they came from and how much they have changed. Visual images have an impact that adds to words and data in a really significant way. We are aiming to use every medium available to help the client progress successfully through treatment whether it’s video, audio or the written word.”

SECURITY AND CONFIDENTIALITY

Recovery Spaces is securely encrypted and has the option to run through its own server or can be installed at the service or treatment centre. A client is given a password which allows access to his or her own Recovery Space; the same password also gives his practitioner and the overall administrator total access.

Clients are unable to search the web via the system and instead use it exclusively for self reflection, record keeping, working and communicating with their keyworker/counsellor. Client registration customises the gathering of detail which can include an assessment of levels of recovery capital, history of addiction and data relevant to the service or treatment centre using the software. Its design is as simple and as easy to use as is possible. The team understands that clients entering treatment will be coming from diverse backgrounds, will be in a variety of physical and mental states and will also possess differing levels of computer skills.

The system is web based, to be used when initial treatment has finished as aftercare support. Clients continue to have a user name and password and will receive email alerts both during (if in the community) and after their treatment.

Ohene-Djan feels that there is a fundamental need to offer multimedia in a way that offers clients “the opportunity to use the most appropriate medium to express their recovery”.

ADDING HUMANITY TO DATA

It has been argued, often in the pages of Addiction Today, that payment by results has turned the relationship between frontline workers and clients into one that exists within a data-mining construct. “When payment-by-results practices are introduced, workers who used to ask their clients ‘How can I help you to achieve what you need ?’ instead think ‘How can you help me to produce the data I need?’” revealed Toby Lowe, CEO of Helix Arts and visiting fellow at Newcastle University Business School.

Ohene-Djan feels that the adoption of a multimedia-based approach brings humanity back into the process. “We must offer a record of recovery. But it is a record that details genuine engagement between client and worker and evidences the great work and achievement that springs from these relationships,” he explained.

MEET Dr Ohene-Djan: He will be presenting in London at the 10th UK/European Symposium on Addictive Disorders 9-11 May 2013 on how to use and apply the latest IT applications and social networking to help people in recovery and the organisations which treat them (www.ukesad.org/programme.html).